Abstract 204: Diabetes Influence Infragenicular Arterial Segment Phospholipid Profiles

Diabetes patient have higher risk of PAD. Our group previously demonstrated that CEA plaque lipidomics are altered by diabetes. It remains unknown whether similar alterations also occur in infra-inguinal PAD. Between 2015 to 2017, patients undergoing major lower extremity amputation were recruited into a vascular surgery tissue biobank. At the time of amputation, infra-inguinal arterial segment with maximally (Max) and minimally (Min) disease were harvested. lipids were extracted using a modified Bligh-Dyer technique and evaluated by Electrospray-ionization tandem mass spectrometry. The relative proportions of all major phospholipid species (including phosphatidylcholine, PC; ceramide, Cer; phosphatidylethanolamine, PE; phosphatidylinositol, PI; and phsophatidylserine, PS) were derived. Paired one-sample sighed rank test was used to evaluate the differences between Max and Min diseased arterial segments, and Wilcoxon two-sample test was used between diabetic and non-diabetic group. 14 diabetic (DM) and 7 non-diabetic(NDM) patients were enrolled with well-matched demographics. Analysis of the major phospholipid families, there were no differences between DM and NDM in Max segments. However in Min segments there were differences (58% lower PI in DM patients, P<0.03). Further sub-group analysis was performed at max and min in DM and NDM separately and found differences in PCs, aPCs, PEs, pPEs, Cers. The most highly differentially expressed lipids included PC 40:3(76%, P=0.01), PC 40:5(60%,P=0.04 ), aPC38:3 (83%, P=0.01), aPC38:2(79%, P=0.04) ,and these have been shown previously to be important in arachidonic acid mediated inflammation. Max and Min diseased segments from infra-ingunial arterial segments from diabetic and non-diabetic patients demonstrate significantly different lipid contents. These findings highlight the profound biochemical differences in plaque phospholipid biology in the diabetes and provide a platform for future exploration in diseased oriented treatment strategies.